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Bossola M, Pepe G, Picca A, Calvani R, Marzetti E. Treating symptoms to improve the quality of life in patients on chronic hemodialysis. Int Urol Nephrol 2019; 51:885-887. [PMID: 30888603 DOI: 10.1007/s11255-019-02121-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/04/2019] [Indexed: 12/18/2022]
Abstract
Health-related quality of life (HRQOL) in patients on chronic hemodialysis has not improved significantly in the last 20 years. This is largely due to their substantial symptom burden which is rarely assessed and treated in routine clinical practice. This is also consequence of the lack of an appropriate armamentarium for the treatments of such symptoms. Adequate studies on the causes and pathogenesis of the symptoms of hemodialysis patients are needed followed by high-quality studies on possible therapeutic pharmacological and non-pharmacological interventions. Patients on chronic hemodialysis deserve a better quality of life.
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Affiliation(s)
- Maurizio Bossola
- Hemodialysis Unit, Institute of Clinical Surgery, Fondazione Policlinico Gemelli, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Gilda Pepe
- Department of Surgery, Fondazione Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Picca
- Department of Gerontology, Fondazione Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Calvani
- Department of Gerontology, Fondazione Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Marzetti
- Department of Gerontology, Fondazione Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
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Bossola M, Pepe G, Marzetti E. Health-related quality of life of patients on chronic dialysis: The need for a focused effort. Semin Dial 2017; 30:413-416. [DOI: 10.1111/sdi.12620] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Maurizio Bossola
- Hemodialysis Unit; Institute of Clinical Surgery; Catholic University of the Sacred Heart; Rome Italy
| | - Gilda Pepe
- Department of Surgery; Catholic University of the Sacred Heart; Rome Italy
| | - Emanuele Marzetti
- Department of Gerontology; Catholic University of the Sacred Heart; Rome Italy
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Lim HA, Yu Z, Kang AWC, Foo MWY, Griva K. The Course of Quality of Life in Patients on Peritoneal Dialysis: A 12-month Prospective Observational Cohort Study. Int J Behav Med 2015; 23:507-14. [DOI: 10.1007/s12529-015-9521-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wan EYF, Chen JY, Choi EPH, Wong CKH, Chan AKC, Chan KHY, Lam CLK. Patterns of health-related quality of life and associated factors in Chinese patients undergoing haemodialysis. Health Qual Life Outcomes 2015; 13:108. [PMID: 26215978 PMCID: PMC4517648 DOI: 10.1186/s12955-015-0308-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 07/17/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients' quality of life and outcomes. There is currently little data on the health related quality of life (HRQOL) of Chinese ESRD patients undergoing HD and this study sought to examine the patterns of HRQOL and its associated factors within this population, as well as in comparison with the general local population. METHODS A cross-sectional study of 244 ESRD patients receiving HD in the hospital and in the community in Hong Kong was conducted using the Short Form-12 Health Survey version 2 (SF-12v2). All study subjects were one-to-one matched with subjects in a Hong Kong general population database by sex and exact age. Independent t-tests were performed to compare the mean SF-12v2 scores between HD patients and the general population, followed by one-way analysis of variance with post hoc Tukey's HSD tests to compare community-based haemodialysis, hospital-based haemodialysis and the general population. Multiple linear regressions were used to identify the factors (socio-demographic, clinical characteristics and comorbidities) associated with the HRQOL scores of ESRD patients receiving HD. RESULTS The SF-12v2 Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Component Summary scores of HD patients were significantly lower than the age-sex adjusted general population. However, the SF-12v2 Mental Health and Mental Component Summary scores of HD patients were significantly higher than the corresponding general population. Poorer HRQOL was associated with being female, smoking, unemployment and hospital-based haemodialysis. CONCLUSIONS HD patients had substantially poorer physical HRQOL but better mental HRQOL than the age-sex adjusted general population. Patients receiving HD in the community setting had better HRQOL. Reasons for these observations will need to be further investigated. Those patients who are female, smokers and unemployed may warrant more attention as their poorer HRQOL may be associated with poorer outcomes.
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Affiliation(s)
- Eric Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
| | - Julie Y Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
- Institute of Medical and Health Sciences Education, The University of Hong Kong, 2/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Edmond P H Choi
- School of Nursing, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
| | - Anca K C Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
| | - Karina H Y Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong.
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Castro JRL, Silva Junior GB, Carvalho AF, Hyphantis TN, Farias LDAB, Libório AB, Daher EF. Cancer patients under maintenance hemodialysis: relationship between quality of life, depression, sleep quality and malnutrition-inflammation score. Blood Purif 2014; 38:46-54. [PMID: 25277248 DOI: 10.1159/000362669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The kidney is one major organ affected by cancer and its associated therapies. The aim of this study was to compare the levels of depression, quality of life and sleep quality in hemodialysis patients with or without cancer, and to analyze the associations with the malnutrition-inflammation score (MIS). PATIENTS AND METHODS In this cross-sectional study, 40 cancer patients under hemodialysis and 44 patients under hemodialysis without cancer who served as the control group were included. Participants underwent structured interviews to investigate depression, quality of life, sleep quality and restless legs syndrome. RESULTS Hemodialysis patients with cancer had a greater depression score (16.5 ± 4.8 vs. 10.8 ± 5.2, p < 0.001). Patients had similar physical and mental composite quality of life scores. Patients under hemodialysis with cancer had poor quality of sleep (mean score 8.8 ± 3.5 vs. 6.4 ± 4.1, p = 0.011) and a higher prevalence of restless leg syndrome (55.9 vs. 25.7%, p = 0.011). These features were associated with MIS in patients without cancer but not in patients with cancer. CONCLUSION Cancer patients undergoing hemodialysis present a higher prevalence of depression, poor quality of life, sleep disorders; however, associations of these features with MIS are different in hemodialysis patients with or without cancer. These findings can change the clinical approach to these patients.
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Anees M, Malik MR, Abbasi T, Nasir Z, Hussain Y, Ibrahim M. Demographic factors affecting quality of life of hemodialysis patients - Lahore, Pakistan. Pak J Med Sci 2014; 30:1123-7. [PMID: 25225539 PMCID: PMC4163245 DOI: 10.12669/pjms.305.5239] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/28/2014] [Accepted: 06/02/2014] [Indexed: 12/02/2022] Open
Abstract
Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients. Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012. Patient of ESRD not on dialysis and Acute Renal Failure were excluded. One hundred and twenty five patients who fulfilled the criteria were included. Demographic data containing age, sex, residence, socio economic status, education, mode of traveling for dialysis, total time consumed in dialysis were collected by the investigators. QOL index was measured using 26 items, WHO QOL BREF. Results: There were 89(71.2%) male and 36(28.8%) female patients. Environmental domain score was highest (p=0.000) than all other domains in HD Patients. In overall analysis age, marital status and total time consumed in getting HD effect QOL significantly (p=<0.05). In domain wise analysis, male has better QOL in social relationship domain than female. Age has negative relationship with physical health and psychological health domain. QOL of unmarried and literate patients is significantly better (p=<0.05) in physical health domain. Employed patients have better QOL in physical, psychological and social relationship domain (p=<0.05) than unemployed patients. Patients of residence of rural areas have better QOL in physical and environment domain. Financial status of HD patients affect QOL in social domain. Distance covered to reach hospital effect QOL in psychological domain (p=<0.05). Patients traveling in private transport have better QOL in environmental domain (p=<0.05). Total time consumed in getting HD effect social relation in QOL (p=<0.05). According to linear regression model, marital status is positive predictor and unemployment is negative predictor of QOL in physical health domain. Age is negative predictor of QOL in psychological domain, monthly income is positive predictor of QOL in domain. Unemployment is positive predictor of QOL in social relation domain. Monthly income and place of residence is positive predictor of QOL in environment domain. Conclusion: Gender, age, marital status, unemployment, residence of rural area, economical status, distance covered to reach hospital, mode of transport, total time consumed in getting HD, effect QOL in HD patient. Education level is a positive factor for improving QOL of HD patients.
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Affiliation(s)
- Muhammad Anees
- Dr. Muhammad Anees, MBBS, FCPS (Nephrology), Assistant Professor of Nephrology, Visiting Consultant Nephrologist, Shalamar Hospital Lahore, Pakistan. King Edward Medical University, Lahore, Pakistan
| | - Muzammil Riaz Malik
- Dr. Muzammil Riaz Malik, MBBS, Registrar Nephrology Department. King Edward Medical University, Lahore, Pakistan
| | - Tanzeel Abbasi
- Dr. Tanzeel Abbasi, MBBS, Postgraduate Trainee, Nephrology Department, King Edward Medical University, Lahore, Pakistan
| | - Zeeshan Nasir
- Dr. Zeeshan Nasir, MBBS, Postgraduate Trainee, Nephrology Department, King Edward Medical University, Lahore, Pakistan
| | - Yasir Hussain
- Dr. Yasir Hussain, MBBS, Postgraduate Trainee, Nephrology Department, King Edward Medical University, Lahore, Pakistan
| | - Muhamamd Ibrahim
- Muhamamd Ibrahim, Associate Professor of Statistics, Registrar, Govt. M.A.O College, Lahore, Pakistan
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Sapkota A, Sedhain A, Rai MK. Quality of life of adult clients on renal replacement therapies in Nepal. J Ren Care 2013; 39:228-35. [PMID: 23855594 DOI: 10.1111/j.1755-6686.2013.12021.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To compare the influence of demographic and clinical variables on quality of life (QOL) amongst haemodialysis (HD) and renal transplantation clients in Nepal. BACKGROUND Renal replacement therapy in the form of renal transplant is a newer modality in Nepal. In this study, effectiveness of renal transplant and maintenance HD in clients with end-stage renal disease were evaluated in a Nepalese context. METHOD A descriptive, cross-sectional study was conducted to compare the QOL of clients undergoing HD and renal transplantation in two treatment centres in Nepal. Information on QOL was collected by using the WHOQOL-BREF instrument through interviews. RESULT The clients in the transplantation groups were significantly younger, highly educated and employed. The QOL score of clients with renal transplantation was significantly higher in the physical, psychological and social relationship domains. While assessing QOL score in transplantation groups, females scored significantly higher score in the environmental domain compared with males. CONCLUSION The QOL score in renal transplant recipients was significantly better than that of clients on HD in three of the four WHOQOL-BREF domains. The limited resources and facilities for renal transplantation and the post-transplant follow-up service in Nepal might have contributed to a poorer outcome on the environmental domain in this group.
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Affiliation(s)
- Abja Sapkota
- College of Nursing, Chitwan Medical College, Tribhuvan University, Bharatpur, Nepal
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The psychological defensive profile of hemodialysis patients and its relationship to health-related quality of life. J Nerv Ment Dis 2013; 201:621-8. [PMID: 23787481 DOI: 10.1097/nmd.0b013e318298294d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Preliminary data suggest that defensive profile of hemodialysis (HD) patients might influence adaptation to the disease. However, the association of defense mechanisms with health-related quality of life (HRQoL) of HD patients remains unknown. In this cross-sectional investigation, 170 HD patients and 170 age- and sex-matched healthy participants had their psychological profile assessed with the Defense Style Questionnaire-40 and the Hospital Anxiety and Depression Scale. Furthermore, the HD patients had their HRQoL measured with the World Health Organization Quality of Life instrument-abbreviated version. The HD patients had a more neurotic and immature defensive profile. Splitting, projection, reaction formation, and denial were significantly associated with impaired HRQoL, independent of psychological distress. Somatization was an independent correlate of worse overall and physical HRQoL. These findings suggest that, apart from the treatment of psychological distress symptoms, clinicians should also consider the defensive profile of HD patients because it is independently associated with HRQoL and may be amenable to treatment.
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Oren B, Enç N. Quality of life in chronic haemodialysis and peritoneal dialysis patients in Turkey and related factors. Int J Nurs Pract 2013; 19:547-56. [PMID: 24330205 DOI: 10.1111/ijn.12098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Turkey is the fifth country in Europe with regard to the number of patients receiving haemodialysis (HD). However, only a limited number of studies have comparatively investigated the factors that affect quality of life in haemodialysis and peritoneal dialysis (PD) patients in Turkey. The purpose of the study was to investigate the factors that affect quality of life in haemodialysis and peritoneal dialysis patients, as well as providing a comparison of quality of life between these groups. In this cross-sectional study, Quality of Life Scale and a data form was completed by 300 dialysis patients who received treatment at five hospital-based dialysis units in Istanbul, Turkey. The data were evaluated using arithmetic mean values, standard deviations, minimums, maximums, percentages, independent groups t-tests, Spearman correlation analyses and one-way variance analyses. The quality of life values in peritoneal dialysis patients were found to be higher than those of haemodialysis patients (P < 0.05). It was concluded that the quality of life in chronic dialysis patients was affected by various factors.
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Affiliation(s)
- Besey Oren
- Health Science Faculty, Istanbul University, Istanbul, Turkey
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Santos PR, Arcanjo FPN. Distance between residence and the dialysis unit does not impact self-perceived outcomes in hemodialysis patients. BMC Res Notes 2012; 5:458. [PMID: 22925177 PMCID: PMC3477091 DOI: 10.1186/1756-0500-5-458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 08/13/2012] [Indexed: 11/30/2022] Open
Abstract
Background Patients have to travel long distances to undergo hemodialysis (HD) in some regions. We aimed to search for an association of the distance between patients’ residence and the dialysis unit with quality of life, depression and coping among end-stage renal disease (ESRD) patients undergoing maintenance HD. Methods We studied 161 ESRD patients undergoing HD during April 2009. Quality of life, depression and coping were assessed by the SF-36, the 10-item CES-D and the Jalowiec Coping Scale, respectively. The sample was stratified in three groups: I-patients residing in Sobral (where the dialysis unit is located); II-patients residing in towns up to 100 km from Sobral; and III-patients residing in towns distant greater than 100 km from Sobral. Analysis of variance was used to detect differences in quality of life and coping scores between the groups. Logistic regression was used to test distance as a predictor of depression. Results There were 47 (29.2%) patients residing in Sobral, 46 (28.6%) up to 100 km away and 68 (42.2%) greater than 100 km from Sobral. There were no differences related to quality of life and coping scores between the groups. Distance was not a predictor of depression. Conclusions Social and cultural factors may explain the lack of differences. Studies from other regions are needed to clarify the distance effects on self-perceived outcomes among HD patients.
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Affiliation(s)
- Paulo Roberto Santos
- Sobral School of Medicine, Federal University of Ceará, Avenida Comandante Maurcélio Rocha Ponte 100, Sobral, 62042-280, Brazil.
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Clinical, sociodemographic, and psychological correlates of health-related quality of life in chronic hemodialysis patients. PSYCHOSOMATICS 2012; 53:30-7. [PMID: 22221719 DOI: 10.1016/j.psym.2011.07.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 07/08/2011] [Accepted: 07/11/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Physical comorbidities and depression are associated with poor health-related quality of life (HRQoL) in patients undergoing chronic hemodialysis, but little is known about the impact of psychological determinants such as coping strategies in this association. This study examined the relation between psychosocial factors, particularly health-related locus of control (HLOC) and quality of life (QoL) in chronic hemodialisys patients. METHODS Three hundred hemodialysis patients underwent assessment of QoL (SF-36), depression (Beck Depression Inventory score), anxiety (State-Trait Anxiety Inventory), and HLOC profile (Multidimensional Health Locus of Control scale). Comorbidities and sociodemographic factors were assessed. RESULTS All QoL scores were low. Depression and comorbidities were negatively correlated with physical QoL components and depression, anxiety, and comorbidities were negatively correlated with mental components. However, internal locus of control (LOC) and external LOC (influence of "powerful others") were positively correlated with mental QoL components. Multiple regression analysis showed internal LOC significantly and positively associated with mental QoL components, especially mental health score (P < 0.01). CONCLUSIONS Altered QoL of patients undergoing chronic hemodialysis is associated with physical and psychiatric comorbidities, in particular depression and anxiety. However, internal and external LOC seem to have differential impact on QoL. Increasing awareness and empowerment of the internal and external components of the LOC could help patients improving QoL.
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Ramirez SP, Macêdo DS, Sales PMG, Figueiredo SM, Daher EF, Araújo SM, Pargament KI, Hyphantis TN, Carvalho AF. The relationship between religious coping, psychological distress and quality of life in hemodialysis patients. J Psychosom Res 2012; 72:129-35. [PMID: 22281454 DOI: 10.1016/j.jpsychores.2011.11.012] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 11/30/2011] [Accepted: 11/30/2011] [Indexed: 01/12/2023]
Abstract
OBJECTIVE No studies have evaluated the relationship among religious coping, psychological distress and health-related quality of life (HRQoL) in patients with End stage renal disease (ESRD). This study assessed whether positive religious coping or religious struggle was independently associated with psychological distress and health-related quality of life (HRQoL) in hemodialysis patients. METHODS This cross-sectional study recruited a random sample of 170 patients who had ESRD from three outpatient hemodialysis units. Socio-demographic and clinical data were collected. Patients completed the Brief RCOPE, the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref). RESULTS Positive or negative religious coping strategies were frequently adopted by hemodialysis patients to deal with ESRD. Religious struggle correlated with both depressive (r=0.43; P<.0001) and anxiety (r=0.32; P<.0001) symptoms. These associations remained significant following multivariate adjustment to clinical and socio-demographic data. Positive religious coping was associated with better overall, mental and social relations HRQoL and these associations were independent from psychological distress symptoms, socio-demographic and clinical variables. Religious struggle was an independent correlate of worse overall, physical, mental, social relations and environment HRQoL. CONCLUSION In ESRD, religious struggle was independently associated with greater psychological distress and impaired HRQoL, while positive religious coping was associated with improved HRQoL. These data provide a rationale for the design of prospective and/or intervention studies targeting religious coping in hemodialysis populations.
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Affiliation(s)
- Susana P Ramirez
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
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Mazairac AHA, de Wit GA, Penne EL, van der Weerd NC, de Jong B, Grooteman MPC, van den Dorpel MA, Buskens E, Dekker FW, Nubé MJ, Ter Wee PM, Boeschoten EW, Bots ML, Blankestijn PJ. Changes in quality of life over time--Dutch haemodialysis patients and general population compared. Nephrol Dial Transplant 2010; 26:1984-9. [PMID: 21051503 DOI: 10.1093/ndt/gfq680] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Improving the health-related quality of life (HRQOL) for haemodialysis patients is a considerable challenge. The aim of the present study was to compare changes in HRQOL in haemodialysis patients with those observed in the general population over a 10-year period and explore factors that might explain possible differences. METHODS We compared 126 haemodialysis patients assessed in 1995 in the Netherlands Cooperative Study on the Adequacy of Dialysis-1 (NECOSAD-I) with 515 patients enrolled in 2006 in the ongoing Convective Transport Study (CONTRAST). Changes in HRQOL in these cohorts were compared with two representative samples from the general Dutch population, assessed in 1992 (n = 1,063) and 2001 (n = 10,600). HRQOL was measured with the SF-36 questionnaire. Differences in HRQOL were analysed with ANCOVA to adjust for demographic variables. To assess possible differences, we used multivariable regression analysis. RESULTS HRQOL in haemodialysis patients in 2006 [CONTRAST, mean age 63 ± 14 years (SD), 62% male] was significantly better than in 1995 (NECOSAD-I, 59 ± 16 years, 53% male) in four domains of the SF-36: bodily pain (+ 5 points, P = 0.009), vitality (+ 7, P < 0.001), role-emotional (+ 14, P < 0.001) and mental health (+ 8, P < 0.001), after adjusting for demographic variables. This increment could partly be explained by improved haemoglobin and phosphate levels. Compared to the general population, HRQOL improvement was most outspoken in two domains: bodily pain (+ 6, P = 0.01) and role-emotional (+ 8, P = 0.007). CONCLUSIONS This study showed an improvement of HRQOL in haemodialysis patients over an 11-year period of time, independent of global changes in the general population.
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Affiliation(s)
- Albert H A Mazairac
- Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands
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